While that number may seem to paint a rosy picture for our fight against superbugs, it really is not. While some members of the 8 have clearly had a major impact on the treatment of high priority drug resistant infections (e.g. ceftolozane-tazobactam, ceftazidime-avibactim, and bedaquiline), some have a limited role.

The summary statistics that are provided for the 8 provide important insight:

6 were developed outside of large pharmaceutical companies and now 7 are marketed by one of three major companies

Only 1 drug showed superiority (as opposed to non-inferiority)

The median time spent in clinical development was 6.2 years

7 of the 8 were from established drug classes

Only 1 is indicated specifically for a drug resistant organism

3 of the 8 have activity against the high value targets known as the ESKAPE pathogens

There are a few implications that I draw from this very informative paper.

Development of a new class of antibiotic is difficult

The prospect of just having a drug indicated for resistant pathogens is one that is not so enticing financially and would require modification of clinical trials to include only those with drug-resistant pathogens

Superiority in the absence of trials only using drug-resistant pathogens is difficult to prove as comparator drugs are also highly effective antibiotics

As the world's eyes turn to the fight against antimicrobial resistant bacteria, it is important to know where we stand and this paper provides an important glimpse of the frontlines of the battle.